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Introduction: The prevalence of Francisella tularensis in Minnesota ticks is unknown. Ticks collected at seven sites were tested to determine the infection prevalence of F. tularensis in D...

Background Canine brucellosis , caused by the bacterium Brucella canis , is a zoonotic and largely reproductive disease of dogs. The disease is a recognized problem in canine breeding populations, and the risk to individuals assisting with birthing is well described. Prior to 2015, all cases of canine brucellosis reported to the Minnesota Board of Animal Health were in dogs used for breeding. In 2015, canine brucellosis was identified in eight Minnesota rescue dogs, all originating from specific geographic areas in South Dakota. Our objective was to measure the seroprevalence of B. canis in stray and previously owned dogs entering a large Minnesota animal rescue organization to determine if our observations represented a localized or generalized disease issue among rescue dogs. Methods A stratified random sample of stray and previously owned dogs entering the largest Minnesota animal rescue organization between November 1, 2016 and November 7, 2017, was tested for B. canis antibodies by the 2-Mercaptoethanol Rapid Slide Agglutination Test (2ME-RSAT) (Zoetis d -TEC® CB kit). Sample sizes for each strata were calculated using previously published seroprevalence estimates. Blood from selected dogs was collected, serum harvested, and transported to the Minnesota Veterinary Diagnostic Laboratory for testing. Positive samples in the 2ME-RSAT were shipped to Cornell University for confirmation by Agarose Gel Immunodiffusion (AGID) testing. Demographics, state and setting of origin, and health status were collected on study-dogs. Results Of the 10,654 dogs accepted by AHS during the study period, 943 (8.9%) were selected for testing. Most study dogs arrived from Oklahoma (28%), Alabama (18%), and Minnesota (12%). The median age of study dogs was 1.5 years; 303 (32%) were intact males and 294 (31%) were intact females. Most study dogs were strays (n = 716, 76%). Of the total, 22 (3.1%) stray and eight (3.5%) owner-surrendered dogs were presumptively positive by RSAT; one (0.11%) of the stray dogs was positive by 2ME-RSAT and confirmed by AGID. The positive dog was a healthy-appearing 1 year-old neutered male beagle from Texas. Conclusions The seroprevalence of canine brucellosis in dogs entering Minnesota for adoption from multiple states was low. Never-the-less, care must to be taken to consider all potential risks and outcomes of interstate and international dog trade, including the spread of infectious diseases such as canine brucellosis.

Q fever is a widely distributed, yet, neglected zoonotic disease, for which domestic ruminants are considered the main reservoirs in some countries. There are still many gaps in our knowledge of its epidemiology, and the source of sporadic cases is often not determined. In this study, we show how Q fever surveillance data in combination with information routinely collected by government agencies in Minnesota during 1997 to 2015 can be used to characterize patterns of occurrence of Q fever illnesses and detect variables potentially associated with increased human illness. Cluster analysis and Bayesian spatial regression modeling revealed the presence of areas in Southern Minnesota at higher risk of Q fever. The number of sheep flocks at the county level helped to explain the observed number of human cases, while no association with the cattle or goat population was observed. Our results provide information about the heterogeneous spatial distribution of risk of Q fever in Minnesota.

We assessed the appropriateness of initiating antibiotics in 49 nursing home (NH) residents receiving antibiotics for urinary tract infection (UTI) using 3 published algorithms. Overall, 16 residents (32%) received prophylaxis, and among the 33 receiving treatment, the percentage of appropriate use ranged from 15% to 45%. Opportunities exist for improving UTI antibiotic prescribing in NH.Infect Control Hosp Epidemiol 2017;38:998–1001

OBJECTIVETo facilitate surveillance and describe the burden of healthcare-associated infection (HAI) in nursing homes (NHs), we compared the quality of resident-level data collected by NH personnel and external staff.DESIGNA 1-day point-prevalence surveySETTING AND PARTICIPANTSOverall, 9 nursing homes among 4 Centers for Disease Control and Prevention (CDC) Emerging Infection Program (EIP) sites were included in this study.METHODSNH personnel collected data on resident characteristics, clinical risk factors for HAIs, and the presence of 3 HAI screening criteria on the day of the survey. Trained EIP surveillance officers collected the same data elements via retrospective medical chart review for comparison; surveillance officers also collected available data to identify HAIs (using revised McGeer definitions). Overall agreement was calculated among residents identified by both teams with selected risk factors and HAI screening criteria. The impact of using NH personnel to collect screening criteria on HAI prevalence was assessed.RESULTSThe overall prevalence of clinical risk factors among the 1,272 residents was similar between NH personnel and surveillance officers, but the level of positive agreement (residents with factors identified by both teams) varied between 39% and 87%. Surveillance officers identified 253 residents (20%) with ≥1 HAI screening criterion, resulting in 67 residents with an HAI (5.3 per 100 residents). The NH personnel identified 152 (12%) residents with ≥1 HAI screening criterion; 42 residents had an HAI (3.5 per 100 residents).CONCLUSIONWe identified discrepancies in resident-level data collection between surveillance officers and NH personnel, resulting in varied estimates of the HAI prevalence. These findings have important implications for the design and implementation of future HAI prevalence surveys.Infect Control Hosp Epidemiol 2016;1440–1445

Adherence to clinical guidelines is recommended to promote appropriate antibiotic use in dentistry and address concerns about increasing antibiotic resistance. Guidelines for antibiotic prophylaxis before invasive dental procedures were updated in 2007 and 2015. In an effort to inform antibiotic stewardship efforts, a study was undertaken to assess the knowledge of antibiotic usage guidelines and antibiotic-prescribing practices among Minnesota dentists. During September 2015, a 22-question online survey was sent to the state dental association membership. Among 437 respondents, dentists reported a median of 4 antibiotic prophylaxis and 5 treatment prescriptions per month. Dentists reported prescribing antibiotics for prophylaxis before invasive dental procedures for patients with "high-risk conditions" (84%) and localized swelling (70%) as well as for a number of reasons that are not recommended by current guidelines, such as an upcoming vacation for the patient (38%), gingival pain (38%), legal concerns (24%), patient demand (22%), and failed local anesthesia (21%). Dentists defined high-risk conditions as a history of infective endocarditis (75%), prosthetic cardiac valve (70%), selected congenital heart disease (68%), cardiac transplantation with cardiac valvulopathy (4%), and primary care physician recommendation (59%). In addition, some dentists assigned a high-risk category to conditions that do not fall within current guideline recommendations, including prosthetic joints (39%), poorly controlled type 2 diabetes (27%), human immunodeficiency virus (18%), chronic kidney disease (13%), mitral valve prolapse (11%), all congenital heart disease (4%), and well-controlled type 2 diabetes (1%). Respondents indicated that common challenges to stewardship of antibiotic use included perceived conflicting provider guidelines (44%), conflicting scientific evidence (44%), or lack of information on antibiotic selection (19%) or risks (23%). Dentists reported greater antibiotic use than currently recommended by existing guidelines. Antibiotic stewardship efforts in dentistry should address challenges to guideline adherence.